Discover and read the best of Twitter Threads about #eular2022
Most recents (13)
#ACR22 spondyloarthritis treatment oral abstract session
🌟Abs 0542 @sofiaramiro82
@official_asas @eular_org revised recommendations for axSpA management
#ACR22
@official_asas @eular_org revised recommendations for axSpA management
#ACR22
@sofiaramiro82 @Official_ASAS @eular_org Abs 0542
Key differences:
🔑added JAK inhibitors to bDMARD considerations
🔑specific EMM recs: monoclonal TNFi for uveitis, IBD; IL17i for PsO
🔑consider taper if in sustained remission
#ACR22
Key differences:
🔑added JAK inhibitors to bDMARD considerations
🔑specific EMM recs: monoclonal TNFi for uveitis, IBD; IL17i for PsO
🔑consider taper if in sustained remission
#ACR22
And here are the CLASSIFICATION criteria for spondyloarthritis (which are NOT diagnostic criteria)
❗️Gaps in knowledge remain:
-lack of biomarkers
-expert rheumatologist opinion as gold std
-MRI findings have low Sp
#ACR22 #ReviewCourse
❗️Gaps in knowledge remain:
-lack of biomarkers
-expert rheumatologist opinion as gold std
-MRI findings have low Sp
#ACR22 #ReviewCourse
#EULAR2022
What is New (WIN)
IgG4
🔆IgG4 is a multi-organ Disease
🔆usually >50
🔆M:F - 3:1
🔆CD4+ cytotoxic cell implicated
🔆 Classification criteria known
What is New (WIN)
IgG4
🔆IgG4 is a multi-organ Disease
🔆usually >50
🔆M:F - 3:1
🔆CD4+ cytotoxic cell implicated
🔆 Classification criteria known
#EULAR2022
What is New (WIN)
IgG4
🔆➕ve correlation with smoking (IgG4 retroperitoneal fibrosis)
🔆 blue Collar Jobs have ⬆️IgG4 (pancreato biliary)
🔆d/t toxic exposures 👉🏻 asbestosis, mineral dust
What is New (WIN)
IgG4
🔆➕ve correlation with smoking (IgG4 retroperitoneal fibrosis)
🔆 blue Collar Jobs have ⬆️IgG4 (pancreato biliary)
🔆d/t toxic exposures 👉🏻 asbestosis, mineral dust
#EULAR2022
What is New (WIN)
IgG4
🔆Role of AutoAb suspected
🔆Anti-IL1RA👉🏻Mediates Inflammation and fibrosis
🔆Anti-Annexin A11👉🏻 damage biliary bicarbonate umbrella
What is New (WIN)
IgG4
🔆Role of AutoAb suspected
🔆Anti-IL1RA👉🏻Mediates Inflammation and fibrosis
🔆Anti-Annexin A11👉🏻 damage biliary bicarbonate umbrella
#EULAR2022
Pain in rheumatic and musculoskeletal diseases
😩Pathophysiology of pain in patients with RMDs is not always Nociceptive and can be nociplastic
😩Differentiation between inflammation-related and unrelated pain is important
Pain in rheumatic and musculoskeletal diseases
😩Pathophysiology of pain in patients with RMDs is not always Nociceptive and can be nociplastic
😩Differentiation between inflammation-related and unrelated pain is important
#EULAR2022
Pain in rheumatic and musculoskeletal diseases
😩Pain can be Nociceptive, Neuropathic and Nociplastic
😩Or can be primary/Secondary
😩Pain sensitisation, processing and response are important for proper assimilation of pain
Pain in rheumatic and musculoskeletal diseases
😩Pain can be Nociceptive, Neuropathic and Nociplastic
😩Or can be primary/Secondary
😩Pain sensitisation, processing and response are important for proper assimilation of pain
#EULAR2022
😩No standard method to measure central pain
😩FMS can be present in upto 50% of patients
😩Asso with Higher disease activity and higher biologic use/change
😩A no. of central mechanisms contribute to pain
😩No standard method to measure central pain
😩FMS can be present in upto 50% of patients
😩Asso with Higher disease activity and higher biologic use/change
😩A no. of central mechanisms contribute to pain
#EULAR2022
What is New (WIN)
Osteoarthritis – evolving treatments
This talk is a must-watch on-demand - highly recommended
🗝Proposed NICE-UK guidelines for
What is New (WIN)
Osteoarthritis – evolving treatments
This talk is a must-watch on-demand - highly recommended
🗝Proposed NICE-UK guidelines for
#EULAR2022
🗝Most trials have tried correcting catabolic pathway
🗝 Most trials in OA have failed
🗝Cartilage though sparsely cellular/vascular exquisitely sensitive to injury
🗝 Max polymorphism in OA is found in the Anabolic pathway
🗝Most trials have tried correcting catabolic pathway
🗝 Most trials in OA have failed
🗝Cartilage though sparsely cellular/vascular exquisitely sensitive to injury
🗝 Max polymorphism in OA is found in the Anabolic pathway
#EULAR2022
What is New (WIN)
Osteoarthritis – evolving treatments
🗝Shear stress leads to damage while compression leads to regeneration
🗝Has been utilized in Joint distraction showing good results
What is New (WIN)
Osteoarthritis – evolving treatments
🗝Shear stress leads to damage while compression leads to regeneration
🗝Has been utilized in Joint distraction showing good results
#EULAR2022
Rheumatology across boundaries
The eye in rheumatic diseases
🧿The Pathophysiology of Uveitis is poorly understood
🧿 Uveitis is thought to be due to enthesitis of ciliary body attachment
🧿TH17 and TH1 are major mediators of inflammation
Rheumatology across boundaries
The eye in rheumatic diseases
🧿The Pathophysiology of Uveitis is poorly understood
🧿 Uveitis is thought to be due to enthesitis of ciliary body attachment
🧿TH17 and TH1 are major mediators of inflammation
#EULAR2022
Rheumatology across boundaries
The eye in rheumatic diseases
🧿 Most common extra-articular feature
🧿 HLA-B27+vity, Recurrent uveitis and IBP 🚩 for rheumatology referral
Rheumatology across boundaries
The eye in rheumatic diseases
🧿 Most common extra-articular feature
🧿 HLA-B27+vity, Recurrent uveitis and IBP 🚩 for rheumatology referral
#EULAR2022
Rheumatology across boundaries
The eye in rheumatic diseases
🧿 Non-Anterior non infectious Uveitis has a no of causes 👉🏻 makes studying the disease difficult
🧿 Sarcoid, Behcet's other imp causes
🧿 Topical Rx 1st for Anterior Uveitis
🧿 Systemic 1st for NIU
Rheumatology across boundaries
The eye in rheumatic diseases
🧿 Non-Anterior non infectious Uveitis has a no of causes 👉🏻 makes studying the disease difficult
🧿 Sarcoid, Behcet's other imp causes
🧿 Topical Rx 1st for Anterior Uveitis
🧿 Systemic 1st for NIU
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸Primary Thromboprophylaxis
🩸Aspirin is recommended but might not be sufficient
🩸VKA use is asso. ⬆️ Bleeding risk (Risk>Benefit)
How To Treat (HOT)
Anti-phospholipid syndrome
🩸Primary Thromboprophylaxis
🩸Aspirin is recommended but might not be sufficient
🩸VKA use is asso. ⬆️ Bleeding risk (Risk>Benefit)
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸Secondary Prophylaxis
🩸INR: 2-3 for venous thrombosis (Controversial)
🩸Is not effective in preventing arterial events though
How To Treat (HOT)
Anti-phospholipid syndrome
🩸Secondary Prophylaxis
🩸INR: 2-3 for venous thrombosis (Controversial)
🩸Is not effective in preventing arterial events though
#EULAR2022
IBD management for Rheumatologist
🔎The options have been increasing over the years
🔎Remission rates have still not crossed 30-40% Ballpark
IBD management for Rheumatologist
🔎The options have been increasing over the years
🔎Remission rates have still not crossed 30-40% Ballpark
#EULAR2022
IBD management for Rheumatologist
🔎Target of therapy is
♦️Clinical remission in short term
♦️Histological remission in medium-term
♦️Disease Modification in Long
🔎Histological activity better marker of future Flare
IBD management for Rheumatologist
🔎Target of therapy is
♦️Clinical remission in short term
♦️Histological remission in medium-term
♦️Disease Modification in Long
🔎Histological activity better marker of future Flare
#EULAR2022
IBD management for Rheumatologist
🔎Very Few Head to head trial to decide biologic of choice
🔎 Vedoli>Adali but Ustki=Adali
IBD management for Rheumatologist
🔎Very Few Head to head trial to decide biologic of choice
🔎 Vedoli>Adali but Ustki=Adali
#EULAR2022
New treatment strategies and approaches to young adults with inflammatory myositis
Treatment options available their doses in IIM
New treatment strategies and approaches to young adults with inflammatory myositis
Treatment options available their doses in IIM
#EULAR2022
New treatment strategies and approaches to young adults with inflammatory myositis
♦️MTX+GC>>MTX+CIC>GC alone
New treatment strategies and approaches to young adults with inflammatory myositis
♦️MTX+GC>>MTX+CIC>GC alone
#EULAR2022
New treatment strategies and approaches to young adults with inflammatory myositis
🪩RIM trial
♦️Better response in JDM
♦️Antibody positive (Mi2,Jo1 +ve ) performed better than Ab negetive
New treatment strategies and approaches to young adults with inflammatory myositis
🪩RIM trial
♦️Better response in JDM
♦️Antibody positive (Mi2,Jo1 +ve ) performed better than Ab negetive
#EULAR2022
Contrasts in pathomechanisms and treatment targets between adult and paediatric inflammatory myositis
👁🗨 Awesome class on IIM pathogenesis
👁🗨The MSA and Phenotype Slide is 👌🏻👌🏻
Contrasts in pathomechanisms and treatment targets between adult and paediatric inflammatory myositis
👁🗨 Awesome class on IIM pathogenesis
👁🗨The MSA and Phenotype Slide is 👌🏻👌🏻
#EULAR2022
Contrasts in pathomechanisms and treatment targets between adult and paediatric inflammatory myositis
👁🗨Summary of Mechanisms
👁🗨DM/JDM👉🏻 CD4 and TH17 mediated
👁🗨 Both Inflammatory and non inflammatory factors contribute
Contrasts in pathomechanisms and treatment targets between adult and paediatric inflammatory myositis
👁🗨Summary of Mechanisms
👁🗨DM/JDM👉🏻 CD4 and TH17 mediated
👁🗨 Both Inflammatory and non inflammatory factors contribute
#EULAR2022
👁🗨 Type I,II IFN sig
👉🏻 DM/JDM>>ASS/PM>IBM>IMNM
👉🏻 Mi2/TIF/MDA5>>Jo1>>SRP/HMCGR
👁🗨⬆️INF levels 👉🏻⬆️ disease activity
👁🗨pDC and mDC mediated
👁🗨Mediate Muscle atrophy(perifasicular) and Capillary loss
👁🗨 Type I,II IFN sig
👉🏻 DM/JDM>>ASS/PM>IBM>IMNM
👉🏻 Mi2/TIF/MDA5>>Jo1>>SRP/HMCGR
👁🗨⬆️INF levels 👉🏻⬆️ disease activity
👁🗨pDC and mDC mediated
👁🗨Mediate Muscle atrophy(perifasicular) and Capillary loss
#EULAR2022
What is New (WIN)
MSK Manifestations in COVID 19 patients
🦠 MSK Pain in COVID can have an Osteometabolic profile
🦠 Mech for autoimmunity include
🔸Molecular mimicry
🔸Cryptic antigen presentation
🔸Epitope spreading
🦠APLs, ACAs and ANAs have been positive
What is New (WIN)
MSK Manifestations in COVID 19 patients
🦠 MSK Pain in COVID can have an Osteometabolic profile
🦠 Mech for autoimmunity include
🔸Molecular mimicry
🔸Cryptic antigen presentation
🔸Epitope spreading
🦠APLs, ACAs and ANAs have been positive
#EULAR2022
What is New (WIN)
MSK Manifestations in COVID 19 patients
🦠Inflammation in COVID is similar to MAS
🔸Has ⬆️Ferritin, ⬆️IL1,IL6 ⬆️ INF signature
(Though usually not as high as in MAS)
What is New (WIN)
MSK Manifestations in COVID 19 patients
🦠Inflammation in COVID is similar to MAS
🔸Has ⬆️Ferritin, ⬆️IL1,IL6 ⬆️ INF signature
(Though usually not as high as in MAS)
#EULAR2022
What is New (WIN)
MSK Manifestations in COVID 19 patients
🦠TCZ, JAKi, IL1 and anti-INF-Gamma Rx has utility in Rx
What is New (WIN)
MSK Manifestations in COVID 19 patients
🦠TCZ, JAKi, IL1 and anti-INF-Gamma Rx has utility in Rx
#EULAR2022
How to treat (HOT)
Difficult to treat RA
🟣 FMS is asso with more severe RA
🟣 Pts with D2T RA have higher comorbidity burden
🟣 Obesity is also a mediator of non Response
How to treat (HOT)
Difficult to treat RA
🟣 FMS is asso with more severe RA
🟣 Pts with D2T RA have higher comorbidity burden
🟣 Obesity is also a mediator of non Response
#EULAR2022
How to treat (HOT)
Difficult to treat RA
This was interesting
🟢 Pts with D2T RA may have a pausi immune phenotype
🟢 This might explain poor response to Rx
How to treat (HOT)
Difficult to treat RA
This was interesting
🟢 Pts with D2T RA may have a pausi immune phenotype
🟢 This might explain poor response to Rx
#EULAR2022
Apples AND/OR oranges? Differentiating common and uncommon arthritides
Enthesitis can be seen in Upto 40% patients with PsA
Enthesitis is associated with
♦️⬆️Disease activity
♦️Synovitis & dactylitis
♦️⬆️Radiographic Damage
♦️ Poor functional Status
Apples AND/OR oranges? Differentiating common and uncommon arthritides
Enthesitis can be seen in Upto 40% patients with PsA
Enthesitis is associated with
♦️⬆️Disease activity
♦️Synovitis & dactylitis
♦️⬆️Radiographic Damage
♦️ Poor functional Status
#EULAR2022
Apples AND/OR oranges? Differentiating common and uncommon arthritides
♦️Fibromyalgia can be seen in 25% of PsA pts
♦️ Asso with
♦️ ⬆️ Disease activity
♦️ Poor Response to Rx 👉🏻 Change of Rx
Apples AND/OR oranges? Differentiating common and uncommon arthritides
♦️Fibromyalgia can be seen in 25% of PsA pts
♦️ Asso with
♦️ ⬆️ Disease activity
♦️ Poor Response to Rx 👉🏻 Change of Rx
#EULAR2022
Apples AND/OR oranges? Differentiating common and uncommon arthritides
♦️ It is very difficult to differentiate Enthesitis from FMS tender points
♦️ they seem to be mutually exclusive 👉🏻 ⬆️ enthesitis in pts without FMS
♦️ USG is the modality of Choice
Apples AND/OR oranges? Differentiating common and uncommon arthritides
♦️ It is very difficult to differentiate Enthesitis from FMS tender points
♦️ they seem to be mutually exclusive 👉🏻 ⬆️ enthesitis in pts without FMS
♦️ USG is the modality of Choice
